Etiology of Tendon Injury

Training errors, such as sudden increase in running distance or a change in activity, are the primary etiological factor in most tendon overuse injuries. Errors include increased frequency of training and running on curved trails, hard or slippery roads, or soft beaches. The principle of transition (according to Leadbetter 1992) is that sports injuries are most likely to occur when the athlete experiences any change in mode or use of the involved part. Transition risk is rate-dependent. Examples of transition risk are attempts
to increase performance level, improper training, changes in equipment, environmental changes such as new surfaces and different training altitudes, alterations in frequency and intensity or endurance of training, attempts to master new techniques, body growth, and post-injury and post-training recovery. Changes of lower leg alignment may also cause tendon problems. Excessive foot pronation may result in increased local strain (elongation) on the medial side of the Achilles tendon and increases the risk of overuse injury. Increased pronation also increases the risk of posterior tibial tendon injuries.